新疆小儿脑性瘫痪防治现状的调查与分析

Investigation and analysis on the current situation of the prevention and control of pediatric cerebral palsy in Xinjiang

目的调查新疆0~6岁小儿脑性瘫痪防治现状,为政府制定脑瘫防治措施的相关政策提供依据。方法2016年5月-2017年5月,对新疆南疆、北疆和东疆3个地区0~6岁227例脑瘫患儿进行现况调查,并对3个地区孕期指导、孕期检查及监护、产后早期发现和早期防治、康复随访监测4个维度等情况进行评价。结果(1)3个地区孕期妈妈在建立围产保健册的机构、孕期妇幼保健机构进行相关营养、卫生、保健指导以及孕妇定期接受指导方面的差异有统计学意义(P<0.05)。(2)3个地区孕妇在妊娠期间是否接受产前检查、接受产前检查机构、定期检查的时间间隔、高危孕妇的胎儿系统监护管理方面的差异有统计学意义(P<0.05)。(3)3个地区在出生后是否有新生儿随访、发现孩子发育异常就诊情况方面的差异有统计学意义(P<0.05)。(4)3个地区在接受康复治疗的方式、医疗机构是否能够制作矫形器及辅助器具、孩子发育异常是否进行随访、孩子发育异常建立监测档案、是否享受医疗保险及新农合报销全部费用、是否享受医疗保险或新农合报销部分费用、政府是否给予专项经济资助方面的差异有统计学意义(P<0.05)。结论新疆小儿脑性瘫痪防治从孕期保健、高危脑瘫患儿筛查、脑瘫早发现、早治疗、全面康复、政策扶持方面均需要完善加强。

Objective To investigate the current situation of cerebral palsy in Xinjiang from 0 to 6 years old,and provide the basis for the government to formulate the relevant policies of cerebral palsy.Methods From May2016 to May 2017,227 cases of cerebral palsy were investigated in regions of Southern Xinjiang,Northern Xinjiang and Eastern Xinjiang.The four dimensions of pregnancy guidance,prenatal examination and monitoring,early postpartum discovery and early treatment and follow-up monitoring were also evaluated.Results（1）There were statistically significant differences in nutrition,hygiene,health guidance and regular guidance for pregnant women in the 3 regions facilities where perinatal health care books were established for pregnant mothers and maternal and child health care during pregnancy（P〈0.05）.（2）There were significant differences in prenatal examination,antenatal examination institution,interval of regular check-up and fetal system monitoring management of high risk pregnant women in the 3 regions during pregnancy（P〈0.05）.（3）There were statistically significant differences in whether there was a follow-up of newborn babies after birth in the 3 regions and in finding children with abnormal development（P〈0.05）.（4）There were statistically significant differences in how to receive rehabilitation treatment,whether the medical institution can make orthopaedic devices and aids, whether children with abnormal development were followed up,whether to establish a monitoring file for children with abnormal development,and whether to enjoy medical insurance and reimbursement for all expenses incurred by New-type Rural Cooperative Medical System（NCMS）,whether to enjoy medical insurance or to reimburse part of the expenses of NCMS,and whether the government would give special financial assistance（P〈0.05）.Conclusion The prevention and control of pediatric cerebral palsy in Xinjiang need to be improved in terms of health care during pregnancy,screening of children with cerebral palsy at high risk,early detection of cerebral palsy,early treatment,comprehensive rehabilitation and policy support.